Department of the Treasury
IRS and Treasury release FAQs about ACA automatic enrollment, employer shared responsibility, and waiting periods
Posted on February 10, 2012
The Internal Revenue Service answered frequently asked questions related to automatic enrollment, employer shared responsibility payments, and waiting periods under the Affordable Care Act (ACA). The notice addressed employers’ questions and invited comments on proposals that the Treasury, Labor, and Health and Human Services departments expect to include in future guidance or rulemaking under the ACA.
The notice included the following information…
Final rule released requiring insurers to use plain language in describing benefits, coverage
Posted on February 9, 2012
Today the Department of Health and Human Services, the Department of Treasury, and the Department of Labor released a final rule requiring insurers to use plain language in describing health plan benefits and coverage under the Affordable Care Act (ACA). The regulations mandate health insurers and group health plans to provide concise and comprehensible information about health plan benefits and coverage to Americans with private health coverage. The new rules will also facilitate easier plan comparison for individuals and employers. The new explanations, available on or soon after September 23, 2012, will be a critical resource for the roughly 150 million Americans with private health insurance. Specifically, these rules will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices…
IRS releases rules on tax exempt entities under the CO-OP Program
Posted on February 6, 2012
The Internal Revenue Service (IRS) released new rules for the Consumer Operated and Oriented Plan (CO-OP) Program regarding what will be recognized as tax exempt under Section 501(c)(29) of the tax code. Proposed and temporary IRS rules denote that qualified nonprofit CO-OP health insurers will need to apply for tax-exempt recognition with IRS. IRS and the Treasury Department will recognize them as exempt effective on either their date of formation or March 23, 2010, the date that the ACA became law. To qualify for a tax exemption, the entity must have received a loan from CMS for operation. IRS’s upcoming revenue procedure requires that a copy of the CMS notice of award and the fully executed loan agreement are included in the entity’s application for exemption.
The IRS temporary rules did include statutory guidance for tax exemption: in addition to notifying the Treasury Department that the group is applying for exemption recognition, no private inurement of earnings to shareholders or individuals can exist, (unless it lowers premiums, improves benefits, or improves the quality of health care delivered to the organization’s members). Additionally, no attempt to influence legislation or politics can be made.
HHS issued the CO-OP final rule in December, which discussed CO-OP Program eligibility standards. For for information on CO-OPs, click here.
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IRS releases Draft Schedule H, instructions for tax-exempt hospitals
Posted on January 6, 2012
The Internal Revenue Service (IRS) has issued a draft Schedule H and accompanying instructions for tax-exempt hospitals. As required by the Affordable Care Act (ACA), non-profit hospitals must respond to questions on financial assistance policies, billing and collection practices, emergency medical care, and individuals eligible for financial assistance, beginning with the 2011 tax filing year. The draft instructions have been revised to more clearly follow the statutory provision of Section 501(r) of the Internal Revenue Code. Several of the changes relate to billing and collections.
For more information on tax-exempt hospital requirements, click here and here.
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Departments release FAQs on ACA, Mental Health Parity
Posted on November 22, 2011
According to a set of frequently asked questions (FAQs) recently released by the Departments of Health and Human Services (HHS), Treasury (DOT), and Labor (DOL), the final rule under an Affordable Care Act (ACA) provision, which requires health care insurers and group health plans to make available to consumers a standardized summary of the benefits and coverage for each plan they offer, will be released “as soon as possible.” The FAQs pertain to implementation of ACA market reform provisions and mental health parity requirements. Until this final rule is released, plans are not required to comply with the proposed rule’s provisions. The ACA requires plans to provide consumers with a standardized form containing definitions of benefits and information on coverage. Along with the benefits and coverage summary, the departments also included several FAQs addressing the implementation of the Mental Health Parity and Addiction Equity Act of 2008, which mandates equal treatment for medical and surgical care and mental health and substance use disorder care in areas such as out-of-pocket costs and benefit limits and practices.
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IRS issues RFC on potential safe harbor for large employers
Posted on September 15, 2011
The Internal Revenue Service (IRS) has released a Request for Comment (RFC) on a potential safe harbor for large employers under the shared responsibility provisions of the Affordable Care Act (ACA). Under the ACA, employers with more than 50 employees must provide affordable health coverage to workers, or else face a penalty. This potential safe harbor would allow employers to base what constitutes affordable coverage on an employee’s wages rather than the employee’s household income, which is something more difficult for employers to know or easily determine.
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IRS Notice and Request for Comments Regarding the Community Health Needs Assessment Requirements for Tax-Exempt Hospitals
Posted on August 23, 2011
On July 7, 2011, the Treasury Department and the Internal Revenue Service (IRS) published a Notice and Request for Comments on a proposed policy regarding the Affordable Care Act’s new requirements related to tax exempt hospitals’ community health needs assessment (CHNA) obligations. Section 9007 of the Act added new Section 501(r) to the Internal Revenue Code, which delineates a series of statutory requirements, outlined in a previous implementation brief, applicable to nonprofit hospitals that seek tax-exempt status under Section 501(c)(3). The purpose of the Treasury/IRS Notice is to both describe the agencies’ approach to implementing hospital organizations’ CHNA obligations and to invite comments regarding their proposals. The CHNA requirements are effective for taxable years beginning after March 23, 2012. However, the Notice specifies that hospitals currently engaged in conducting CHNA-related activities — including development and wide publication of a needs assessment and adoption of an implementation strategy — can rely on the policies contained in the Notice as they move forward.
Treasury, DOL, HHS issue new rules on providing insurance information to consumers
Posted on August 17, 2011
The Internal Revenue Service (IRS) of the U.S. Department of Treasury (Treasury), The Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) have jointly-released two Notices of Proposed Rulemaking (NPRMs) covering the disclosure of the Summary of Benefits and Coverage and the Uniform Glossary to insurance consumers, aimed at providing clear, consistent, and comparable information about their health plan. The rules apply to group health plans and health insurance coverage in the group and individual markets under the Affordable Care Act (ACA), and include not only what must be disclosed to consumers, but also examples of the templates on which the information will be disclosed.
TIGTA releases final report regarding TE/GE Division’s planning activities for the ACA
Posted on August 17, 2011
The Treasury Inspector General for Tax Administration (TIGTA) recently performed an audit on the Affordable Care Act (ACA) and the the Health Care and Education Reconciliation Act of 2010. TIGTA performed the audit to review the Tax Exempt and Government Entities (TE/GE) Division’s initial planning activities for ACA implementation. The TIGTA review did not identify any concerns relating to the methodology the TE/GE Division is using to monitor and coordinate planning efforts.
HHS and IRS release NPRMs on exchange eligibility, tax credits, medicaid expansion
Posted on August 12, 2011
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have released Notices of Proposed Rulemaking (NPRM) on Exchange eligibility and insurance premium tax credits, respectively. Additionally, the Centers for Medicare and Medicaid Services (CMS) has released an NPRM related to the Medicaid eligibility expansion authorized by the Affordable Care Act (ACA).
All three NPRMs are designed to simplify Exchange eligibility and enrollment by coordinating with state Medicaid agencies and the IRS to determine eligibility for premium tax credits and Medicaid under the new expanded eligibility rules laid out in the ACA. Also addressed in the proposed rules is the eligibility and calculation of tax credits for small businesses.
For more information on the Medicaid eligibility expansion, click here. For more information on tax credits, click here. For more information on Exchange eligibility, click here. Finally, for more information on tax credits for small businesses, click here.
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